Resting metabolic rate in women with bulimia nervosa: a cross-sectional and treatment study.

Two studies on resting metabolic rate (RMR) in bulimia nervosa were conducted. The first study compared RMR before treatment in 25 normal-weight women with bulimia nervosa and 20 control subjects of similar height, weight, body composition, age, and activity level. No significant difference in RMR adjusted for fat-free weight was observed. The second study sought to determine whether RMR in women with bulimia nervosa changed if they ceased vomiting and resumed eating in a more normal fashion after cognitive-behavioral treatment. There was no differential change in RMR from pre- to posttreatment for the "improved" bulimics (9 of 12 subjects who received treatment) relative to 13 control subjects who were also tested twice at the same time intervals as the treated bulimia nervosa subjects. These findings do not support the hypothesis that normal-weight women with bulimia nervosa have a suppressed RMR, nor is it altered with treatment compared with matched control subjects.

Behavioral economic analysis of activity choice in obese children.

Evaluated children's choice for sedentary versus vigorous activity. Experiment 1 assessed the influence of percent overweight (less than 20%, 20% to 80%, greater than 80%) on choice of a moderately liked vigorous activity at a constant variable ratio (VR) 2 reinforcement schedule versus a highly liked sedentary activity with the schedule varied from VR2 to VR32. All children chose the sedentary choice when the schedules were VR2. As the cost for sedentary activity increased, lean and moderately obese children switched to the vigorous activity, but the very obese children still chose the sedentary activity. Experiment 2 compared moderately obese children's choice between easily accessible, highly or least liked vigorous activities (VR2) and highly liked sedentary activity with the schedule varied from VR2 through VR16. When the reinforcement schedules were equal, and sedentary activity and vigorous activity were rated as equally linked, children chose the sedentary activity. All subjects switched from the sedentary to the vigorous activity, but there were no differences in choice as a function of liking for vigorous activities.

Effects of decreasing sedentary behavior and increasing activity on weight change in obese children.

Obese children 8-12 years old from 61 families were randomized to treatment groups that targeted increased exercise, decreased sedentary behaviors, or both (combined group) to test the influence of reinforcing children to be more active or less sedentary on child weight change. Significant decreases in percentage overweight were observed after 4 months between the sedentary and the exercise groups (-19.9 vs. -13.2). At 1 year, the sedentary group had a greater decrease in percentage overweight than did the combined and the exercise groups (-18.7 vs. -10.3 and -8.7) and greater decrease in percentage of body fat (-4.7 vs. -1.3). All groups improved fitness during treatment and follow-up. Children in the sedentary group increased their liking for high-intensity activity and reported lower caloric intake than did children in the exercise group. These results support the goal of reducing time spent in sedentary activities to improve weight loss.

Comparison of cognitive-behavior therapy and desipramine in the treatment of bulimia nervosa.

A comparison of cognitive-behavior therapy alone, desipramine alone, and cognitive-behavior therapy combined with desipramine was made in the treatment of bulimia nervosa. The study was terminated early with an N of only 7 subjects per condition because of a high drop-out rate and lack of positive response in the desipramine alone group compared to the other two groups. By this time it was also apparent that at posttreatment and at 6 months follow-up no benefit was being realized from combining cognitive-behavior therapy with desipramine.